Acne Scars, Pores & Texture
– Rebuild the Surface with Dermapen 4, Sofwave™ or Polynucleotides. Planned by Dr Nish Shah MD, Mayfair

Acne scars can be significantly improved but not fully removed, and how much depends on the scar type. Rolling scars (shallow and soft-edged) and boxcar scars (sharp-edged) respond well to treatments that rebuild collagen beneath them: a Dermapen 4 microneedling course, Sofwave™ ultrasound, or both. Ice-pick scars, the narrow deep pits, respond least to any non-surgical treatment and improve rather than disappear. Dr Nish Shah MD maps your scars by type at consultation and tells you what to expect from each before anything is planned.

For rolling and boxcar scars, a Dermapen 4 microneedling course of 3–6 sessions is the first-line treatment at Medisha, because it rebuilds collagen directly beneath each scar at a depth set for that scar; Dermapen 4 is FDA-cleared, including for acne scars in adults aged 22 and over. Sofwave™, which is also FDA-cleared for acne scars, rebuilds collagen across a wider area in one session with no downtime and is often combined with Dermapen 4. Polynucleotides come first where the skin is still red or reactive. Which you need, and in what order, is decided at consultation.

Acne scarring usually needs a course of up to 6 Dermapen 4 sessions, 4 weeks apart; texture, pores and marks usually need three. Each session makes thousands of micro-channels that the skin fills with new collagen, and the collagen keeps building for months after the last session, so the final result is reviewed at 6 months rather than at the end of the course. Dr Nish sets the number of sessions and the depth for each zone of your face at consultation.

At Medisha Clinic in Mayfair, Dermapen 4 microneedling is priced per session and per course of 3 or 6 on the Dermapen 4 page, with course prices confirmed at consultation. Sofwave™ full face is £1,400 for one session. Polynucleotides are £350 per session or £950 for the course of 3. Profhilo is £350 per session or £700 for 2. Reviews at 4 weeks and 6 months are included. Consultation with Dr Nish is £50, redeemable in full against treatment. The clinic is at 58 South Molton Street, Mayfair, London W1K 5SL, 3 minutes from Bond Street station.

Yes — Dermapen 4 microneedling does not use heat or light, so it does not target pigment and carries a low risk of pigmentation in darker skin, which is why it is often chosen over lasers for acne scars in skin of colour. Sofwave™ is ultrasound and does not target pigment either. The depth plan is adjusted for skin type, and strict SPF is part of the aftercare for everyone. Dr Nish assesses your skin at consultation as he would for any patient.

Dermapen 4 is comfortable under numbing cream applied for 20–30 minutes; most patients describe a scratching or vibrating sensation rather than pain. Afterwards the skin is red and warm, like sunburn, for 24 to 48 hours, then dry and flaky for a few days, and make-up can go on after 24 hours. Sofwave™ has no downtime beyond mild redness for a few hours. Polynucleotides leave small bumps for a day. The clinic gives written aftercare and its direct contact details on the day.

Not until the active acne is under control, because microneedling over inflamed spots can spread the bacteria and make scarring worse. If you still break out, that is managed first, and scar treatment starts once the skin has been clear for a few weeks. Polynucleotides can be used in the meantime to calm reactive, red post-acne skin. Dr Nish assesses this at consultation.

Yes — open pores and rough texture are the same collagen damage on a smaller scale, and a Dermapen 4 course of 3 sessions usually improves both, with the surface noticeably smoother under make-up within weeks of the course. Profhilo afterwards adds hydration and glow to the rebuilt surface. Sofwave™ improves texture across the whole face as it builds collagen. Dr Nish plans texture and scars together in one course.

Sofwave™ is FDA-cleared for the treatment of acne scars and can be used on its own where the scarring is spread across a wider area and the skin has also loosened, because it builds collagen beneath the whole area in one session with no downtime. For defined rolling and boxcar scars, a Dermapen 4 course rebuilds the surface more directly, and the two are often combined: Sofwave™ first, then the course. Dr Nish tells you which at consultation.

Dr Nish Shah MD assesses your scars, writes the depth plan for every zone of your face and reviews the result; a trained aesthetic nurse delivers each Dermapen 4 session to his plan. Sofwave™, polynucleotides and Profhilo are performed by Dr Nish personally. This is the model used by every clinic offering microneedling well: the doctor decides the depth, the nurse delivers it, and the doctor checks the outcome.

Side effects are mild and temporary for most patients: redness and warmth for 24 to 48 hours after Dermapen 4, dryness and flaking for a few days, occasionally a small bruise or a brief flare of spots. Pigmentation is uncommon with microneedling and ultrasound because neither targets pigment, and strict SPF reduces it further. Infection is avoided with a new sterile cartridge at every session. A history of keloid scarring is assessed case by case. All risks are explained at consultation.

Medisha Clinic maps acne scars by type and treats each differently, with Dermapen 4 microneedling delivered to a depth plan written by Dr Nish Shah MD, Sofwave™ as an official partner clinic for scars that need collagen rebuilt beneath a wider area, and polynucleotides for skin that is still reactive. Dr Nish is the Senior International Clinical Trainer at Derma Medical and, with over 30,000 non-surgical treatments, one of the most experienced aesthetic doctors in the UK and London. He tells you which of your scars will respond and which will not, before anything is planned. Rated 5.0 on Google from 128 reviews. 58 South Molton Street, Mayfair, London W1K 5SL, serving Mayfair and Marylebone.